Associated Physicians & Practitioners LLC

Organization Active NPI Surgery Physician · Clovis, NM

NPI 1235385303 · NPPES record last updated Oct 17, 2024

Key facts

NPI
1235385303
Entity type
Organization (NPI type 2)
Primary specialty
Surgery Physician 208600000X
License
82.61 (NM)
Legal business name
ASSOCIATED PHYSICIANS & PRACTITIONERS LLC
Practice address
1833 W 21St St
Clovis, NM 88101-4023
Phone
(575) 763-5585
Fax
(575) 763-5160
NPI assigned
Aug 8, 2008
Organization subpart
No

Authorized official

Name
Dr. Stephen H Haynes, M.D.
Title
Member
Phone
(575) 763-9800

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NM

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20090423000039 NM Part B Supplier - Clinic/Group Practice 5395893796 Receives reassigned benefits from 1 practitioner
Practice locations: Clovis, NM

National Provider Directory

Locations

1937 W 21st St
Clovis, NM 88101
Phone (505) 742-2500

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP
208600000X 82.61 NM Yes
General Practice Physician
Group: 193200000X MULTI-SPECIALTY GROUP
208D00000X 82.61 NM

Addresses

Primary practice location

1833 W 21St St
Clovis, NM 88101-4023

Mailing address

1833 W 21St St
Clovis, NM 88101-4023
Phone (575) 763-5585

Other identifiers

IdentifierTypeStateIssuer
19018MedicaidNM

Other providers in Clovis, NM

All providers in Clovis, NM · Surgery Physician in New Mexico

Sources for this page

Verify at the official NPI Registry.